There are many strategies that an athlete can utilize to minimize unwanted GI symptoms that can sometimes occur with exercise, supplementation during exercise, or exercise that entails long distances or long time frames. Certainly, not all athlete's GI symptoms are created equally so what may work for one athlete may not work for another athlete. And of course, if you are an athlete with a pre-existing medical condition, especially a particular GI issue such as Chron's disease as an example, recommendations go beyond what is suggested here. So with all of that said here are some general recommendations and strategies one might employ to make sure or GI symptoms remain happy during exercise:

Adequate training - make sure that before you decide to put in the 26.2 mile run or 100 mile bike ride that you have trained sufficiently and that your body, especially your GI system has adapted to that level of exercise intensitiy.

Exercise change-up - switching from running to cycling or running to swimming on an intermittent or permanent basis may be beneficial as both cycling and swimming are much less jarring an activity and may help to reduce stomach upset. For an athlete with minimal GI issues just intermittently utilizing a less jarring activity may solve the problem. For an athlete with minimal GI toleration, switching to a less jarring activity may need to be more of permanent change.

Pay attention to hydration - Making sure that an athlete is well hydrated both before, during and after athletic activity is critical to minimizing GI symptoms. This can be a balancing act and hydration requirements vary from body to body and certainly depend upon the length, frequency, intensity of exercise, and outdoor or indoor temperature. Certainly an athlete competing in an outdoor event in Florida in August would have different hydration requirements than an athlete completing an indoor treadmill run. However, limiting intake to 600 - 1000 ml/hr along with consuming small volumes of liquid on a more frequent basis may be helpful.

Avoid solutions that are hypertonic in nature - this will minimize any GI bloating or aggravation of gastric reflux.

Avoid any sudden or dramatic changes in diet - changing your diet just prior to event competition is a no-no amongst athletes. Stick with a diet that your GI system is familiar with and make changes during your non-competitive training times.

Avoid consuming any large meals immediately prior to competition. This will put undue stress on the GI system and most likely lead to unwanted issues and problems

Minimize the use of anti-inflammatory medications - certainly, if you are having to compete with a known injury or are in the process of healing from an older injury, might be best to utilize more side effect free treatment modalities such as acupuncture, chiropractic, massage, or sublingual homeopathic remedies that will not cause untwanted GI side effects due to their sublingual administration. It has been now well documented the GI and cardiovascular side-effects of non-steroidal anti-inflammatory medications.

Avoid the use of excessive amounts of GI stimulants such as caffeine. Although contained in many supplemental sport gels, in this form it is in a more GI friendly form

Yes! Acupuncture is a safe, natural, drug-free, effective way to help manage and alleviate shoulder pain. The Shoulder is the most mobile joint in the body. It has many ranges of motion including flexion, extension, internal rotation, external rotation, abduction and adduction. This allows us to perform activities like combing our hair, putting our hands behind our back, lifting things in front or behind our bodies. So, one can see that shoulder pain and or restriction of motion of this joint can really interrupt our life and daily activities and especially cause issue for participation in athletic activities. Most commonly treated with Acupuncture is a condition called "Frozen Shoulder". It is a condition that affects the shoulder joint involving pain and stiffness that develops gradually, may worsen, and than finally goes away. In Chinese medicine pain and stiffness, particularly in one location with pain feeling sharp or stabbing is due to "Qi and Blood Stasis". Simply put there is a deficient amount of energy and blood flow in the area that is causing symptoms of pain. Acupuncture points are selected both at the shoulder area and at other points on the body to restore blood flow to the painful area and re-energize the shoulder. This is often used in combination with TuiNa massage, Cupping, Electro-Acupuncture, Auricular(Ear) Acupuncture, or Acupoint Injection Therapy (Acupoint Injection Therapy). Also recommended and frequently utilized is the the addition of Homeopathic, Chinese Herbal and Nutritional Remedies to further decrease pain and accelerate the healing process. Recommended frequency of treatment is usually once or twice weekly sessions with a gradual decrease in treatment frequency as pain resolves. Cases that are either minimally responsive or unresponsive to treatment may be referred for Western imaging studies such as MRI and X-rays and referral to a Western medicine specialist.

Yes, Acupuncture, Electro-Acupuncture, Cupping, and Moxa Therapy are all some of the methods that we utilize at the Florida Institute of Acupuncture but there is a faster way to recovery from pain! Acupoint Injection Therapy By strict definition, Acupoint Injection Therapy means the injection of herbs, homeopathics, and other nutritional supplements into acupuncture points to promote, retain, restore health and prevent disease. Acupoint Injection Therapy may activate acupuncture points much in the same way as the insertion of needles with additional healing provided by the remedies that are utilized during the injection. Substances injected are sterile and promote tissue healing without the side effects of western medical injections which usually contain steroids as an injectable component. There are no steroids utilized in an Acupoint Injection. The injection is of a superficial nature utlizing small gauge needles so discomfort is minimal, it is quick, easy and many patients will notice a positive response to their pain levels shortly after treatment. It is effective for the treatment of neck, shoulder, knee, low back, hip and foot pain along with sciatica, tennis elbow, achilles tendonitis and carpal tunnel syndrome. Acupoint Injection Therapy should only be performed by a licensed acupuncturist certified in Acupoint Injection Therapy.

Heart disease and Hypertension are both a common affliction in the United States often managed by an array of pharmaceuticals that usually require patients to try multiple anti-hypertensives with multiple untoward side effects. Hypertension and especially those patients classified as Pre-Hypertensive should be aware of natural products and methodologies they can use to help control thier blood pressure and possibly in the long term prevent the condition from worsening. Traditonal Chinese Medicine and Acupuncture looks at Hypertension as being related to the Liver, which according to Traditional Chinese Medicine plays a role in the control of our emotions. Emotional upset(STRESS) causes a rise in Liver Yang, or the energy force of the liver in a negative way. So Acupuncture and Chinese Herbal Formulas are directed at "subduing" the LIver Yang and controlling the emotions. Nutritional therapy is also an effective modality to help reduce blood pressure. Targeted supplementation utilizing Coenzyme Q10, Magnesium, Fish Oil, Garlic, and Hawthorne are effective strategies. It is best to institute the use of one or combination of these products in situations of mild or pre-hypertensive cases prior to western pharmaceuticals to see if use of these products lower the blood pressure within normal range. In these cases, patients may not have to move foward with western anti-hypertensive pharmaceuticals as long as blood pressure remains in normal range. For patients that are already taking western anti-hypertensive pharmaceuticals, these products can be added but only under the direct supervision of physician. CoQ10, Magnesium, Garlic and Hawthorne have the general effect on reducing the constriction of the blood vessels whereas Fish Oil can also reduce cholesterol and triglyceride levels.

Many patients inquire about the benefits of Acupuncture for the treatment of Arthritis. Can it help my joint pain? Will I be able to walk, run, and do the activities I used to enjoy with less discomfort? The answer is YES! The insertion of needles thru Acupuncture at tender or what is known as Ashi points, can stimulate the release of chemical substances know as endorphins from the brain. The release of endorphins interact with opiate receptors in the brain to reduce our perception of pain, providing us with the pain relief of drugs like morphine and codeine but without the unwanted side effects. Acupuncture will not cure the arthritis, however it is an effective, safe, side effect free answer to pain reduction for an arthritic joint! The use of nutritional therapy, select chinese herbal formulas, and herbal compounds aimed at nourishing the joint structures, reducing inflammation, strengthening collagen, removing stagnant blood and circulating qi(energy) are complimentary therapies that are used along with Acupuncture to further improve joint function, improve mobility and reduce pain. Traditional Chinese Medicines considers pain associated or due to Arthritis as a result of pathogens such as wind, cold, heat, or dampness that attack the joints and result in a blockage of the flow of blood and qi(energy) creating the joint pain scenario. Acupuncture and Herbal theory focus on specific acupuncture points and herbal formulas aimed at helping to remove the wind, cold, heat or dampness that is attacking the joint and thus releasing the blockage of blood flow and qi(energy) restoring the joint to a balanced and pain free state. Other modalities, such as infrared heat and moxa therapy are also helpful and recommended. Treatment frequency initially may be once or twice weekly with gradual reduction as symptoms improve.

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